AIDS scourge needlessly hits South Africa

May 14, 2000|By Gwynne Dyer

SIXTEEN MONTHS ago I was sitting in the AIDS clinic at Baragwanath Hospital in Soweto, the biggest hospital in South Africa, playing with a bright, cheeky little girl who reminded me of my own younger daughter. Her parents, a young couple who had driven down all the way from Pietersburg for a diagnosis, were dressed up as if they were going to church - or as if showing how respectable and promising they were would somehow ward off the diagnosis of HIV-positive that would destroy their little family.

She was a beautiful, happy 2-year-old, and she probably had less than two years to live. Her parents would likely outlive her just long enough to torture themselves with might-have-beens and destroy their own relationship before they followed her into the grave.

It is the fate that awaits millions of South Africans. Yet, 16 months ago there was hope on the AIDS front in South Africa.

True, the government was not providing the drug AZT to expectant mothers who were HIV-positive (22 percent of pregnant women in South Africa), even though the drug is known to cut the rate of HIV transmission from mother to infant by half. Too expensive, explained the health minister.

But the government's stonewalling on AZT was then part of a larger strategy. It was trying to subvert the whole price system that put all anti-AIDS drugs, including the very expensive cocktail of anti-retrovirus drugs that fights the onset of full-blown AIDS, far beyond the reach of most South Africans. Not submitting to the drug companies' pricing policies on AZT made sense as part of that strategy.

In order to extract the maximum revenue for their drugs from the world's many countries, the drug companies divide them into different price zones based on average middle-class income. American consumers pay about three times as much as Poles for the same drugs, and Poles pay around three times as much as Indians. And to maintain the integrity of this system, the holders of the drug patents forbid any international trade in their drugs that crosses the borders between these zones.

This system hits South Africa especially hard because the high average income of its white population (very few of whom are HIV-positive) boosts it into the high-price category, making the drugs impossibly expensive for the poor black majority. Up to a quarter of South Africa's non-whites face death from AIDS in the next 10 years - the sort of casualty rate a country might suffer in a nuclear war - but under former president Nelson Mandela, the government did have a strategy to bring the price down.

In 1997, the South African parliament passed the Medicines Act, authorizing the government to import drugs directly from low-price sources like India. Forty drug companies immediately challenged the legality of the measure in the South African courts, and the U.S. government launched a major arm-twisting campaign on their behalf. But given the popular sympathy that the legislation commanded both at home and abroad, there was a good chance that South Africa would get away with it in the end, saving millions of lives.

Mr. Mandela is retired, however, and President Thabo Mbeki has different ideas. Specifically, he has fallen for the junk science that asserts that HIV is not the cause of AIDS, that AZT does more harm than good, and even that the high incidence of AIDS in Africa is due more to poverty than to unprotected sex.

The subtle and intelligent anti-AIDS strategy of the past is out the window. In its place is a pseudo-science based on desperate hope and willful ignorance that guarantees an ultra-rapid spread of HIV. It is a disaster that threatens the whole country's future, for when South Africa's death rate from AIDS climbs past a million a year and then heads for two million (in a country of only 45 million), all hope of development, and even of political stability, will vanish.

How can Mr. Mbeki, an intelligent and sophisticated man, have fallen for such vicious nonsense?

In every great plague of the past, powerful currents of irrationality and denial have swept the afflicted population. The AIDS plague is no different. But it is a great and needless tragedy when measures that would alleviate the suffering are available, and the man who bears the greatest responsibility for putting them into effect succumbs to the madness.

Gwynne Dyer is a London-based independent journalist whose articles are published in 45 countries.